‘Salt’ MRI May Show Greater Detail in Kidney Scans

MRI experts at
the University of Nottingham have won a £1 million grant to conduct research
using the body’s natural sodium (salt) content that could lead to greater
detail in kidney scans.

The research, that
will provide a more detailed picture of tissue health and disease, is to be
pioneered by the magnetic resonance imaging (MRI) team at the Sir Peter
Mansfield Imaging Centre (SPMIC), and will
explore ways to improve the diagnosis and treatment of other diseases related
to the brain, lung, liver and musculoskeletal system.

The university
explained in an announcement
that current clinical MRI uses hydrogen in the body’s water and fat to produce
scans, but this does not provide all the information about tissue health and
disease progression stages. Sodium ions naturally occurring in the body are
much smaller than water molecules and are involved in many body functions
associated with pathology. Sodium MRI has great potential to be a useful new
high and ultra-high field scanning target in the future.

Kidney disease
will be the main application of the research working in collaboration with the
Centre for Kidney Research and Innovation (CKRI),
but the team believes that sodium MRI can also be used for more accurate
diagnosis and monitoring of other diseases, and perhaps will give new insights
into disease mechanisms as sodium management is important in the brain, lung,
liver, and musculoskeletal system.

The MRC
Discovery Grant of £672,000 with a £369,000 investment from the university will
allow the researchers to develop sodium MRI on the 3T and 7T magnetic field
scanners at the SPMIC, University Park Campus, Nottingham. The team will
use MRI coils for sodium imaging, these are the receivers of radiofrequency
signals in the MRI scanner specifically tuned to the resonant frequency of
sodium ions. The researchers will develop new pulse sequences so that these new
coils can image the torso and limb. The team hopes eventually to take sodium
MRI technology from bespoke research into real world healthcare in healthy
volunteers and patients.

“Sodium MRI is a
novel and undeveloped technology which has huge potential for the healthcare of
the future,” said Translational imaging researcher Dr Galina
Pavlovskaya, School of Medicine, SPMIC.

“The technique
of using sodium ions in the body as a biomarker for imaging is very challenging
because of the lower detectability of the sodium signal in biological tissue by
currently available MRI scanners. However, high and ultra-high magnetic field
scanners available in the Centre should be able to help to circumvent this
obstacle,” Dr Pavlovskaya added.

“Sodium ions are
much smaller than the hydrogen protons bound to oxygen molecules in the water
in our bodies which are mapped by conventional MRI. Therefore, sodium has the
capacity to give us a much clearer and detailed picture of the structure and
health of an organ from deep inside the tissue. Our aim is to refine the
technology so we can turn theory into clinical reality.”

“The team has a
special interest in new types of functional MRI using novel targets like sodium
as quantitative biomarkers of disease in the body, in particular in the kidney,”
added Co-researcher Dr Susan Francis,
School of Physics, SPMIC.

“The kidney is an
ideal target for our project because it is important in the regulation of
sodium in the body. If we can image how sodium is distributed in the kidney and
how that differs in a diseased kidney, the impact on the diagnosis and
treatment of kidney injury or disease is potentially great. The technique also
has specific relevance to understanding sodium and water balance in dialysis
patients.

“Sodium
accumulation in the skin is a biomarker for kidney stress, but we will also be
examining how salt is distributed in the skin and muscle. This has lots of
clinical applications, for diseases like muscular dystrophy for example.
Theoretically, we should also be able to study sodium concentration in red
blood cells which again has major implications for disease diagnosis and
treatment. The technique will give a picture of the body’s naturally occurring
sodium and how it is trafficked in the body and will not require any invasive
addition of sodium to the scanned subject,” Dr Francis concluded.

The work will
involve scanning healthy volunteers and combining conventional proton MRI to
track water in the body with sodium MRI to analyse the concentration and flow
of sodium ions. Chronic kidney disease or acute kidney injury patients will
then take part in a second small trial to assess the new sodium MRI technique.

The project will
end in 2018 with a Sodium MRI Conference for the worldwide MRI research and
clinical community.

Earlier, the
SPMIC announced
a major breakthrough in new MRI scan technology for lung disease.

The experts at
the SPMIC developed a process using specially treated krypton gas as an
inhalable contrast agent to make the spaces inside the lungs show up on an MRI
scan. It’s hoped the new process will eventually allow doctors to virtually see
inside the lungs of patients.

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